Nokea
Following drugs have disulfiram-like reaction when taken with alcohol EXCEPT
- A. Sulfonylureas
- B. Amoxicillin
- C. Metronidazole
- D. Cefoperazone
Correct Answer: B
Rationale: Metronidazole, cefoperazone, and some sulfonylureas cause a disulfiram-like reaction (flushing, nausea) with alcohol by inhibiting aldehyde dehydrogenase; amoxicillin does not.
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A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages?
- A. Increased renal secretion
- B. Increased medication-metabolizing enzymes
- C. Liver failure
- D. Peripheral vascular disease
Correct Answer: C
Rationale: Liver failure impairs metabolism, and concurrent use of medications metabolized by the same pathway can increase drug levels, both necessitating lower doses.
A nurse is preparing to administer a prescribed drug by the oral route. Which of the following would be most important for the nurse to do? Select one that does not apply.
- A. Making sure the client is in an upright position prior to administration
- B. Ensuring that a full glass of water is readily available
- C. Encourage patient to take a few sips of water before placing the medicine in the mouth
- D. Instructing the client to tilt his or her head back to swallow a capsule
Correct Answer: D
Rationale: Clients should always be in an upright position when receiving oral drugs and a glass of water should be readily available. They should be encouraged to take a few sips of water before placing the tablet or capsule in the mouth. Drugs should never be left at the client's bedside. Instruct clients to tilt their head back to swallow a tablet and slightly forward to swallow a capsule.
A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?
- A. Notify the registered nurse.
- B. Administer pain medication to reduce the discomfort.
- C. Apply ice and maintain the infusion rate, as prescribed.
- D. Elevate the extremity of the IV site, and slow the infusion.
Correct Answer: A
Rationale: When antineoplastic medications (Chemotherapeutic Agents) are administered via IV, great care must be taken to prevent the medication from escaping into the tissues surrounding the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then contact the health care provider.
Drugs mostly cross biological membranes by
- A. Passive diffusion
- B. Active diffusion
- C. Active transport
- D. Carrier mediated transport
Correct Answer: A
Rationale: Most drugs cross membranes via passive diffusion based on concentration gradients.
The nurse administers an intravenous medication with a half-life of 24 hours but recognizes what factors in this patient could extend the drug's half-life? (Select one that does not apply.)
- A. Gastrointestinal disease
- B. Kidney disease
- C. Liver disease
- D. Cardiovascular disease
Correct Answer: A
Rationale: Kidney disease could slow excretion and extend the drug's half-life. Liver disease could slow metabolism resulting in an extended half-life. Cardiovascular disease could slow distribution resulting in a longer half-life. Gastrointestinal disease would not impact half-life because the medication was injected directly into the bloodstream. Route of administration would not extend half-life because IV injection eliminates the absorption step in the process.